Surveillance of carbon monoxide-related incidents - Implications for prevention of related illnesses and injuries, 2005-2014

Am J Emerg Med. 2018 Oct;36(10):1837-1844. doi: 10.1016/j.ajem.2018.02.011. Epub 2018 Feb 13.

Abstract

Background: Carbon monoxide (CO) is an insidious gas responsible for approximately 21,000 emergency department visits, 2300 hospitalizations, and 500 deaths in the United States annually. We analyzed 10 combined years of data from two Agency for Toxic Substances and Disease Registry acute hazardous substance release surveillance programs to evaluate CO incident-related injuries.

Methods: Seventeen states participated in these programs during 2005-2014.

Results: In those 10years, the states identified 1795 CO incidents. Our analysis focused on 897 CO incidents having injured persons. Of the 3414 CO injured people, 61.0% were classified as general public, 27.7% were employees, 7.6% were students, and 2.2% were first responders. More than 78% of CO injured people required hospital or pre-hospital treatment and 4.3% died. The location for most injured people (39.9%) were homes or apartments, followed by educational facilities (10.0%). Educational services had a high number of people injured per incident (16.3%). The three most common sources of CO were heating, ventilation, and air conditioning systems; generators; and motor vehicles. Equipment failure was the primary contributing factor for most CO incidents.

Conclusions: States have used the data to evaluate trends in CO poisoning and develop targeted public health outreach. Surveillance data are useful for setting new policies or supporting existing policy such as making CO poisoning a reportable condition at the state level and requiring CO alarms in all schools and housing. Public health needs to remain vigilant to the sources and causes of CO to help reduce this injury and death.

Keywords: CO; Carbon monoxide poisoning; NTSIP; Toxic substance surveillance.

MeSH terms

  • Air Pollution, Indoor / adverse effects*
  • Carbon Monoxide Poisoning / epidemiology*
  • Chemical Hazard Release / statistics & numerical data*
  • Environmental Monitoring
  • Equipment Failure
  • Hazardous Substances / adverse effects*
  • Health Surveys
  • Housing / legislation & jurisprudence
  • Housing / standards*
  • Humans
  • Population Surveillance
  • Registries
  • United States / epidemiology
  • Wounds and Injuries / chemically induced*
  • Wounds and Injuries / epidemiology

Substances

  • Hazardous Substances